Tibia cisim k�r�klar�nda iki farkl� cerrahi y�ntemin kompartman bas�nc� �zerine etkisi: Tav�an modelinde deneysel bir �al��ma

Ert�rk, Cemil; Altay, Mehmet Akif; Altay, Nuray; �zt�rk, �brahim Av�in; Baykara, �slam; Sert, Cemil; I��kan, U�ur Erdem

30/4Gelecek Say� Ar�iv Kapaklar Pop�ler Makaleler

ICMJE COI Form

H�zl� Arama

Tibia cisim k�r�klar�nda iki farkl� cerrahi y�ntemin kompartman bas�nc� �zerine etkisi: Tav�an modelinde deneysel bir �al��ma [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2017; 23(2): 85-90 | DOI: 10.5505/tjtes.2016.82177

Tibia cisim k�r�klar�nda iki farkl� cerrahi y�ntemin kompartman bas�nc� �zerine etkisi: Tav�an modelinde deneysel bir �al��ma

Cemil Ert�rk¹, Mehmet Akif Altay¹, Nuray Altay², �brahim Av�in �zt�rk¹, �slam Baykara¹, Cemil Sert³, U�ur Erdem I��kan¹
¹Harran �niversitesi T�p Fak�ltesi, Ortopedi ve Travmatoloji Anabilim Dal�, �anl�urfa
²Harran �niversitesi T�p Fak�ltesi, Anesteziyoloji ve Reanimasyon Anabilim Dal�, �anl�urfa
³Harran �niversitesi T�p Fak�ltesi, Biyofizik Anabilim Dal�, �anl�urfa

AMA�: Kompartman i�i bas�n� (K�B) monitarizasyonu �zellikle tibia cisim k�r�klar�n�n intramed�ller �ivilemesinden sonra s�k�a kullan�lan bir izlem y�ntemidir. �lizarov sirk�ler fiksat�r (�CF) ile tespit yap�lan tibia k�r�klar�ndaki K�B de�erlerinin intramed�ller telleme (�MT) ile yap�lanlardan daha d��k olabilece�i �ng�r�ld�. Bu �al��mada, �CF ve �MT ile tespit yap�lan tibia k�r�klar�nda K�B de�erleri kar��la�t�r�ld�.
GERE� VE Y�NTEM: Yirmi Yeni Zelenda Beyaz tav�anlar� rastgele �CF (Grup 1) ve �MT (Grup 2) olmak �zere iki gruba ayr�ld�lar. Anestezi alt�nda tav�anlar�n sa� tibialar�n�n �st yar�s�nda k�r�k olu�turuldu. Tibia k�r�klar� Grup 1�de �CF, Grup 2�de �MT ile tespit edildi. Kompartman i�i bas�n� de�erleri 48 saat boyunca alt��ar saat arayla �l��ld�.
BULGULAR: Kompartman i�i bas�n� de�erlerinde her iki grup i�inde �nemli farklar vard� (p<0.001). Ayr�ca, her iki grupta K�B de�erleri ameliyat sonra ilk 24 saatte �nemli derecede artarken, ikinci 24 saatte azalm��t�. En �nemlisi de, �CF grupta K�B de�erleri �MT gruptakine g�re, 30, 36 ve 42. saatlarda �nemli derecede d��kt� (p<0.05).
TARTI�MA: Tespitten 24 saat sonra, �CF grubundaki K�B de�erleri �MT�ye g�re daha d��kt�. Bu sonu�lar tibia k�r�klar�nda �CF kullan�m�n�n �n kompartmanda ek dekompresyon sa�lad��n� g�stermektedir. Bu bulgular�n ��nda, �CF uygulamas� kompartman sendromu riski ta��yan y�ksek riskli tibia k�r�klar�n tedavisinde tercih edilebilir.

Anahtar Kelimeler: Akut kompartman sendromu, �lizarov eksternal fiksat�r, intramed�ller �ivi tespiti, kompartman i�i bas�n� monitarizasyonu; tibia k�r�klar�.

The effect of 2 different surgical methods on intracompartmental pressure value in tibial shaft fracture: An experimental study in a rabbit model

Cemil Ert�rk¹, Mehmet Akif Altay¹, Nuray Altay², �brahim Av�in �zt�rk¹, �slam Baykara¹, Cemil Sert³, U�ur Erdem I��kan¹
¹Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, �anl�urfa-Turkey
²Department of Anesthesiology and Reanimation, Harran University Faculty of Medicine, �anl�urfa-Turkey
³Department of Biophysics, Harran University Faculty of Medicine, �anl�urfa-Turkey

BACKGROUND: Intracompartmental pressure (ICP) monitoring is a widely used modality, particularly after intramedullary nailing of tibial shaft fractures. It was hypothesized that ICP value in fracture fixed with Ilizarov circular fixator (ICF) might be lower than in fracture fixed with intramedullary pin (IMP). The present study is a comparison of ICP value in tibial fractures in a rabbit model fixed with ICF and IMP.
METHODS: Twenty male New Zealand White rabbits were randomly divided into 2 groups of equal size: ICF group (Group 1) and IMP group (Group 2). Under anesthesia, half of proximal part of the right tibia of all rabbits was fractured. Tibial fractures were fixed with ICF in Group 1 and IMP in Group 2. ICP values were monitored at 6-hour intervals for 48 hours.
RESULTS: There was statistically significant difference in ICP value between groups (p<0.001). While there was statistically significant increase in ICP values 24 hours post surgery, there was statistically significant decrease during second 24 hours following surgery. Most importantly, ICP values of ICF group were significantly lower than those of IMP group at 30, 36, and 42 hours post surgery (p<0.05).
CONCLUSION: At 24th hour after fixation, ICP values measured in ICF group were lower compared with those of IMP group. These results indicate that use of ICF in tibial fractures provides additional decompression in the anterior compartment. In light of these findings, ICF may be preferable for treatment of tibial fractures with high risk for compartment syndrome.

Keywords: Acute compartment syndrome, Ilizarov external fixator, intracompartmental pressure monitoring, intramedullary pin fixation; tibial fractures.

Cemil Ert�rk, Mehmet Akif Altay, Nuray Altay, �brahim Av�in �zt�rk, �slam Baykara, Cemil Sert, U�ur Erdem I��kan. The effect of 2 different surgical methods on intracompartmental pressure value in tibial shaft fracture: An experimental study in a rabbit model. Ulus Travma Acil Cerrahi Derg. 2017; 23(2): 85-90

Sorumlu Yazar: Cemil Ert�rk, T�rkiye
Makale Dili: �ngilizce

ARA�LAR Tam Metin PDF Yazd�r Al�nt�y� �ndir RIS EndNote BibTex Medlars Procite Reference Manager E-Postala Payla� Yazara e-posta g�nder Benzer makaleler PubMed Google Scholar